Applying implementation science in mental health services: Technical assistance cases from the Mental Health Technology Transfer Center (MHTTC) network

Heather J Gotham; Janet R Cummings; Joni N Dolce; Benjamin Druss; Kenneth J Gill; Sarah L Kopelovich; Todd Molfenter; Jonathan R Olson; Felicia Benson; Lydia Chwastiak

doi:10.1016/j.genhosppsych.2022.01.004

Applying implementation science in mental health services: Technical assistance cases from the Mental Health Technology Transfer Center (MHTTC) network

Gen Hosp Psychiatry. 2022 Mar-Apr:75:1-9. doi: 10.1016/j.genhosppsych.2022.01.004. Epub 2022 Jan 19.

Authors

Affiliations

¹ Mental Health Technology Transfer Center Network Coordinating Office, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: gothamh@stanford.edu.
² Southeast Mental Health Technology Transfer Center, Department of Health and Policy Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
³ Northeast and Caribbean Mental Health Technology Transfer Center, Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, NJ, USA.
⁴ Northwest Mental Health Technology Transfer Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Washington, DC, USA.
⁵ Great Lakes Mental Health Technology Transfer Center, Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.
⁶ Mental Health Technology Transfer Center Network Coordinating Office, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.

PMID: 35078020
DOI: 10.1016/j.genhosppsych.2022.01.004

Abstract

Objective: Critical gaps exist between implementation of effective interventions and the actual services delivered to people living with mental disorders. Many technical assistance (TA) efforts rely on one-time trainings of clinical staff and printed guidelines that alone are not effective in changing clinical practice. The Mental Health Technology Transfer Center (MHTTC) Network uses implementation science to accelerate the use of evidence-based practices (EBPs), improve performance, and bring about systems-level change.

Method: Four case examples illustrate how MHTTCs employ the Exploration-Preparation-Implementation-Sustainment (EPIS) implementation framework and intensive implementation strategies to educate clinicians, manage change, and improve processes. These examples include implementing motivational interviewing, cognitive-behavioral therapy for people with psychosis, strategies to decrease the no show rate for virtual appointments, and school mental health systems development.

Results: From Preparation through Sustainment, MHTTCs successfully employed implementation strategies including learning communities, audit and feedback, and coaching to bring about change. Each project attended to inner and outer contexts to eliminate barriers. The examples also show the benefit of integrating process improvement alongside implementation.

Conclusions: The MHTTCs are a model for using implementation science to design technical assistance that leads to more successful practical execution of EBPs; thus reducing the gap between research and practice.

Keywords: Implementation; Mental health services; Technical assistance.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Evidence-Based Practice
Humans
Implementation Science*
Mental Health
Mental Health Services*
Technology Transfer